The associations of phthalate biomarkers during pregnancy with later glycemia and lipid profiles.

Abstract

BACKGROUND:

Pregnancy induces numerous cardiovascular and metabolic changes. Alterations in these sensitive processes may precipitate long-term post-delivery health consequences. Studies have reported associations between phthalates and metabolic complications of pregnancy, but no study has investigated metabolic outcomes beyond pregnancy.

OBJECTIVES:

To examine associations of exposure to phthalates during pregnancy with post-delivery metabolic health.

DESIGN:

We quantified 15 urinary phthalate biomarker concentrations during the second and third trimesters among 618 pregnant women from Mexico City. Maternal metabolic health biomarkers included fasting blood measures of glycemia [glucose, insulin, Homeostatic Model Assessment of Insulin Resistance [HOMA-IR], % hemoglobin A1c (HbA1c%)] and lipids (total, high-density lipoprotein (HDL), low-density lipoprotein (LDL) cholesterol, triglycerides), at 4-5 and 6-8 years post-delivery. To estimate the influence of the phthalates mixture, we used Bayesian weighted quantile sum regression and Bayesian kernel machine regression; for individual biomarkers, we used linear mixed models.

RESULTS:

As a mixture, higher urinary phthalate biomarker concentrations during pregnancy were associated with post-delivery concentrations of plasma glucose (interquartile range [IQR] difference: 0.13 SD, 95%CrI: 0.05, 0.20), plasma insulin (IQR difference: 0.06 SD, 95%CrI: -0.02, 0.14), HOMA-IR (IQR difference: 0.08 SD, 95% CrI: 0.01, 0.16), and HbA1c% (IQR difference: 0.15 SD, 95%CrI: 0.05, 0.24). Associations were primarily driven by mono-2-ethyl-5-carboxypentyl terephthalate (MECPTP) and the sum of dibutyl phthalate biomarkers (∑DBP). The phthalates mixture was associated with lower HDL (IQR difference: -0.08 SD, 95%CrI: -0.16, -0.01), driven by ∑DBP and monoethyl phthalate (MEP), and higher triglyceride levels (IQR difference: 0.15 SD, 95%CrI: 0.08, 0.22), driven by MECPTP and MEP. The overall mixture was not associated with total cholesterol and LDL. However, ∑DBP and MEP were associated with lower and higher total cholesterol, respectively, and MECPTP and ∑DBP were associated with lower LDL.

CONCLUSIONS:

Phthalate exposure during pregnancy is associated with adverse long-term changes in maternal metabolic health. A better understanding of timing of the exact biological changes and their implications on metabolic disease risk is needed.

• Authors: Haotian Wu, Allan C Just, Elena Colicino, Antonia M Calafat, Emily Oken, Joseph M Braun, Nia McRae, Alejandra Cantoral, Ivan Pantic, María Luisa Pizano-Zárate, Mary Cruz Tolentino, Robert O Wright, Martha M Téllez-Rojo, Andrea A Baccarelli, Andrea L Deierlein
• Journal: Environment international (Environ Int) Vol. 155 Pg. 106612 (10 2021) ISSN: 1873-6750 [Electronic] Netherlands
• PMID: 33965768 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Biomarkers
• Blood Glucose
• Environmental Pollutants
• Lipids
• Phthalic Acids
• phthalic acid

Topics

• Bayes Theorem
• Biomarkers
• Blood Glucose
• Environmental Exposure (adverse effects, analysis)
• Environmental Pollutants (toxicity)
• Female
• Humans
• Lipids
• Phthalic Acids (toxicity)
• Pregnancy